Title: Medical Care Research Unit
1Acupuncture for low back pain a pragmatic
randomised controlled trial Hugh MacPherson
PI Kate Thomas
Deputy DirectorMedical Care Research
UnitFaculty of MedicineUniversity of Sheffield,
UK
Research Director Foundation for Traditional
Chinese Medicine, York, UK
2Testing the hypothesis that.
-
- . primary care patients with persistent low
back pain, when given access to an acupuncture
service, gain more relief from pain than those
offered usual management only, for equal or less
cost.
3Pragmatic research design - evaluating
comparative effectiveness
-
- Patients with low back pain (duration 4 to 52
weeks) - Referred by their General Practitioner (GP)
- Randomised to receive either
- 10 individualised acupuncture treatments as well
as usual GP management - usual GP management only
or
4Outcomes at 3, 12 and 24 months
- Primary outcome
- SF-36 Bodily Pain (scale 0 to 100)
- at 12 and 24 months
- Economic measures at 24 months
- SF-6D, EQ-5D
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6Demographic profiles (at baseline)
7Acupuncture treatments provided
- Average 8 treatments per patient, usually weekly
- Commonly selected points
- Bladder points BL-23, BL-26, BL-53, BL-40
- Gall Bladder points GB-30, GB-34
- Local points Huatou at L3, L4 and L5, AhShi
points - Syndrome points KID-3
- Auxiliary techniques and advice
8SF-36 Bodily Pain Scale 3 months
Diff5.5 pts p0.079
9SF-36 Bodily Pain Scale 12 months
Diff6.0 pts P0.074
Diff5.5 pts p0.079
10SF-36 Bodily Pain Scale 24 months
Diff9.0 pts P0.015
Diff6.0 pts P0.074
Diff5.5 pts p0.079
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12Worry about back pain at 24 months
Diff. between groups Plt0.001
13At randomisation Do you believe that
acupuncture can help your low back pain?
14Conclusions
- It is possible to conduct a pragmatic RCT of
individualised acupuncture in primary care - Acupuncture is clinically beneficial (and
cost-effective) for low back pain over the
longer-term - Results are unlikely to be due to belief
15Acknowledgements
- Acupuncturists
-
- Wendy Epstein
- Alison Gould
- Liping Han
- Harriet Lansdown
- Hugh MacPherson
- June Tranmer
- Advisors
- David Laverick
- Trevor Sheldon
- Sally Bell?Syer
- Patients
- Research Team
-
- Kate Thomas (PI)
- Hugh MacPherson
- Lucy Thorpe
- John Brazier
- Mike Campbell
- Mike Fitter
- Ann Morgan
- Jon Nicholl
- Liz Oswald
- Mark Roman
- Helen Wilkinson
- Funders
-
- NHS Health Technology
- Assessment Programme